Effects of buckles in joining vitrectomy for complicated retinal detachment

Objective:To determine if scleral buckling is of any additional benefit in repair of complicated retinal detachment with vitrectomy. Methods:166 eyes with complicated retinal detachment repaired with vitreous surgery combined with scleral buckling (34 eyes) or without scleral buckling (132 eyes) were studied.The long-term retina reattachment rate,ocular axial length,and visual acuity were examined. Results:Comparing the buckling group with non buckling group,no significant differences were found.In the buckling group and no buckling group,the total retina reattachment rates were 70 58% (24 eyes to 34 eyes) and 78 03% (103 eyes to 132 eyes),the improvements of postoperative corrected visual acuity were 44 11% (15 eyes to 34 eyes) and 44 6% (59 eyes to 132 eyes).In scleral bucking group,the average ocular axial length were 24 0921±2 2197mm preoperatively and 25 9854±2 4518mm postoperatively,respectively,and the differences were significant (P0 05).In non buckling group,the average ocular axial length were 24 5656±2 4518mm and 25 5256±4 3720mm,respectively,but no differences were found (P0 05). Conclusions:Scleral buckling may not be necessary in complicated retinal detachment if repaired with vitrectomy,peeling,endolaser photocoagulation and intraocular tamponade.Thorough peeling with relaxing retinotomy,sufficient photocoagulation or cryotherapy,and effective gas or silicone oil tamponade,are the keys to the surgery for complicated retinal detachment;the scleral buckling,however,is not requisite.